From the Guidelines
Treating partners of individuals with bacterial vaginosis (BV) is not recommended as a routine practice. The current standard of care focuses on treating only the person diagnosed with BV, typically with antibiotics such as metronidazole or clindamycin 1. BV is not considered a sexually transmitted infection in the traditional sense, although sexual activity can disrupt vaginal flora.
Key Points to Consider
- The benefits of therapy for BV in nonpregnant women are to relieve vaginal symptoms and signs of infection, and reduce the risk for infectious complications after abortion or hysterectomy 1.
- Treatment of the male sex partner has not been beneficial in preventing the recurrence of BV 1.
- The recommended treatment regimen includes oral or topical metronidazole or clindamycin cream 1.
- Follow-up visits are unnecessary if symptoms resolve, but recurrence is not unusual and patients should return for additional treatment if symptoms recur 1.
Prevention and Management
- Patients should be advised to avoid douching, use condoms consistently, and minimize the number of sexual partners.
- Partner treatment has not been shown to significantly reduce BV recurrence rates in most studies 1.
- However, in cases of persistent or recurrent BV, some clinicians might consider partner treatment on a case-by-case basis, though this remains outside standard guidelines.
- No long-term maintenance regimen with any therapeutic agent is recommended for preventing recurrence 1.
From the Research
Treatment of Partners
- The treatment of partners of patients with bacterial vaginosis (BV) is not universally recommended, as data do not support the practice of routine treatment of male sex partners of infected females 2.
- There is no evidence to suggest that treating partners would prevent recurrence or improve treatment outcomes for women with BV.
- The current focus of treatment is on the elimination of symptoms in the infected individual, rather than on treating their partners.
Recurrence and Reinfection
- Recurrence of BV is a common problem, with 50-80% of women experiencing a recurrence within a year of completing antibiotic treatment 3, 4.
- Reinfection from partners is considered a possible cause of recurrence, but the underlying mechanisms of recurrent etiology of BV are not fully understood.
- The formation of a biofilm that protects BV-causing bacteria from antimicrobial therapy is thought to be a factor in persistence and recurrence of BV 3.
Current Treatment Approaches
- The current and only FDA-approved treatment regimens for BV are antibiotics, such as metronidazole and clindamycin 4, 2.
- Alternative strategies, including probiotics, prebiotics, and antimicrobial substances, are being studied as potential adjuncts or replacements for standard therapies 5.
- Behavioral modifications, such as smoking cessation and condom use, may also help prevent recurrence and improve treatment outcomes 4.